PMID- 22465400
OWN - NLM
STAT- MEDLINE
DCOM- 20120906
LR  - 20221207
IS  - 1873-460X (Electronic)
IS  - 1056-8727 (Linking)
VI  - 26
IP  - 2
DP  - 2012 Mar-Apr
TI  - Stratifying healthcare costs using the Diabetes Complication Severity Index.
PG  - 107-12
LID - 10.1016/j.jdiacomp.2012.02.004 [doi]
AB  - OBJECTIVE: We aim to determine whether healthcare costs for patients diagnosed 
      with Type 2 Diabetes Mellitus (T2DM) are associated with the severity of diabetes 
      complications as measured by the Diabetes Complication Severity Index (DCSI). 
      METHODS: Retrospective cohort analysis was performed on a 2007 primary care 
      cohort of T2DM patients. The DCSI is a 13-point scale, which comprises 7 
      categories of complications and their severity levels. Healthcare cost data from 
      2008 and 2009 were used as primary outcome. Inpatient and outpatient costs 
      incurred for services consumed by patients within the provider network were 
      included. Generalized linear model with log-link and gamma distribution was used 
      to predict healthcare costs. RESULTS: Of the 59,767 T2DM patients, 2977 (5.0%) 
      deaths occurred and 1336 (2.2%) were lost to follow up. Healthcare cost was 
      strongly associated with increase in DCSI score. Compared to patients without 
      complications, those with more complications (higher DCSI score) had an increased 
      risk of higher healthcare costs. Risk ratio (RR) increased from 1.25 (95%CI: 
      1.19-1.32) for DCSI=1 to 1.61 (1.51-1.72) for DCSI=2; 2.10 (1.91-2.31) for 
      DCSI=3; 2.52 (2.21-2.87) for DCSI=4 and 3.62 (3.09-4.25) for DCSI>/=5. As a 
      continuous score, a one-point increase in the DCSI was associated with a cost 
      increase of 27% (95%CI: 1.25-1.29). CONCLUSION: The DCSI score is a useful tool 
      for predicting direct healthcare costs. The DCSI can be used to triage high-risk 
      patients for more focused secondary prevention interventions at primary care 
      level, in a bid to lower overall healthcare costs.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Wu, C X
AU  - Wu CX
AD  - Health Services and Outcomes Research, National Healthcare Group, Singapore 
      149547. Christine_WU@juronghealth.com.sg
FAU - Tan, W S
AU  - Tan WS
FAU - Toh, M P H S
AU  - Toh MP
FAU - Heng, B H
AU  - Heng BH
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120331
PL  - United States
TA  - J Diabetes Complications
JT  - Journal of diabetes and its complications
JID - 9204583
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Aged
MH  - Diabetes Complications/*economics/mortality
MH  - Diabetes Mellitus, Type 2/complications/economics/mortality
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - *Health Care Costs
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Severity of Illness Index
EDAT- 2012/04/03 06:00
MHDA- 2012/09/07 06:00
CRDT- 2012/04/03 06:00
PHST- 2011/07/20 00:00 [received]
PHST- 2012/02/21 00:00 [revised]
PHST- 2012/02/21 00:00 [accepted]
PHST- 2012/04/03 06:00 [entrez]
PHST- 2012/04/03 06:00 [pubmed]
PHST- 2012/09/07 06:00 [medline]
AID - S1056-8727(12)00006-2 [pii]
AID - 10.1016/j.jdiacomp.2012.02.004 [doi]
PST - ppublish
SO  - J Diabetes Complications. 2012 Mar-Apr;26(2):107-12. doi: 
      10.1016/j.jdiacomp.2012.02.004. Epub 2012 Mar 31.